Thesis health care reform

In recent years, the healthcare system has undergone dramatic changes. Competition in the healthcare market has pushed facilities into cutbacks, layoffs, and consolidation of various services to patients. Without proper regulation in quality control, the potential for negative effects on patient care can be expected. Implementation of quality assurance methods can provide most healthcare facilities with an improvement to services even in light of this changing environment. The Institute for Healthcare Improvement is a recent initiative that demonstrates redesigned clinical practices designed for improvement in performance that is relevant for immediate social demands.

This initiative develops system-wide approaches in clinical care, information services, and access and efficiency.

The development and implementation of effective preventive services in clinical practice is an important issue. While healthcare, in and of itself, is predominantly viewed as the diagnosis and treatment of abnormal states of human functioning, preventive healthcare contributes to eliminating or, at the very least, delaying such conditions.

Assessing the needs of a healthcare facility for preventive care programs is necessary through the review of patient records and determining which elements of preventive care have been managed appropriately. Once a facility determines the need for a more vigorous approach to preventive care services, the proper steps to achieving a successful program must be followed.

In order to implement preventive care, clear guidelines for intervention and proper staff training are necessary. A policy of preventive care should be developed that is specific to the facilities practice and patient needs. Universal Health Care - However, they all share the goal of improving the general health outcomes of the entire nation. Ethics in Health Care - In today's litigious society, ethics in health care is a very relevant topic to produce a research paper on for any health care or pre-med course. Healthcare Financing - Healthcare Financing research papers discuss what approach a student should take on when researching healthcare financing.

Health Care Economics - Health Care Economics research papers analyze the increasing costs of health care as new technologies are introduced. Health Care Delivery System - Health Care Delivery System research papers discuss modern nomenclature for any organization of institutions, people and resources that deliver health care to a given population. Health Care Industry - Health Care Industry Research Papers explore an example of an order of a research paper on the health care industry with focus on the global segment, competitive forces, and alliances. Diversity Healthcare - Diversity Healthcare research papers discuss how healthcare professionals should approach diversity in healthcare.

Health Care Reform - Health Care Reform research papers discuss term used to describe changing health policy in a given country, specifically in the United States. Healthcare Information Systems - This research paper on healthcare information systems look into the computer- based systems that have become increasingly critical to hospital settings. Affordable Health Care Act - Affordable Health Care Act research papers examine the legislation, passed by Congress in , to increase the availability of health insurance and access to the health care system for millions of American citizens.

Remaking Healthcare in America - Remaking Healthcare in America Research Papers examines the last two decades of the United States and the healthcare changes that have taken place. This page is designed to show you how to write a research project on the topic you see here. Use our sample or order a custom written research paper from Paper Masters. In November , a series of videos emerged of Gruber speaking about the ACA at different events, from to , in ways that proved to be controversial; the controversy became known in the press as "Grubergate".

He said this obfuscation was needed due to "the stupidity of the American voter" in ensuring the bill's passage. Gruber said the bill's inherent "lack of transparency is a huge political advantage" in selling it. In two subsequent videos, Gruber was shown talking about the decision which he attributed to John Kerry to have the bill tax insurance companies instead of patients the so-called "Cadillac tax" , which he called fundamentally the same thing economically but more palatable politically.

In one video, he stated that "the American people are too stupid to understand the difference" between the two approaches, while in the other he said that the switch worked due to "the lack of economic understanding of the American voter". In another video, taken in , Gruber expressed doubts that the ACA would significantly reduce health care costs, although he noted that lowering costs played a major part in the way the legislation had been promoted.

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After the first of these videos came out, Gruber apologized and conceded he "spoke inappropriately". Some defenders of the ACA, such as Jonathan Cohn , called Gruber's statements about Americans "wrong and inappropriate" while maintaining that the trickery of which Gruber spoke was standard procedure in passing legislation in Washington, D. Conservative S. Nancy Pelosi , then-Speaker of the House, who successfully shepherded the legislation through the House of Representatives , without a single GOP vote and despite some opposition from pro-life Democrats, stated in a press conference after the Gruber controversy, "So I don't know who he is.

He didn't help write our bill" , a comment PolitiFact described as "inaccurate". In the wake of the controversy, Jonathan Gruber was called to testify before members of United States Congress. He gave testimony on December 9, , in which he apologized for his remarks, which he called "glib, thoughtless, and sometimes downright insulting". On December 17, , Vermont Governor Peter Shumlin cancelled the Vermont health care reform plan, on which Gruber had served as a consultant.

Writing a Research Paper on Healthcare Reform

The extent of Gruber's contributions to both Massachusetts and federal health care reform has been the source of significant controversy. According to emails released by the U.

House Oversight Committee to the Wall Street Journal , Gruber met and consulted with various Obama administration officials in charge of writing and developing the law, [56] including Peter Orszag , who was director of the Office of Management and Budget OMB , Jason Furman , an economic adviser to the president, Ezekiel Emanuel , who was then a special adviser for health policy at OMB, Jeanne Lambrew , a top Obama administration health adviser who worked at HHS and the White House, and Lawrence Summers , then a top economic adviser in the administration.

From Wikipedia, the free encyclopedia. Jonathan Gruber. MIT Economics. Retrieved December 16, The Washington Post.

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Changes in the structure of employer-provided health insurance. Retrieved January 9, Retrieved July 25, Mitt Romney for signing Massachusetts' historic health care reform". The Republican. Harvard Kennedy School.


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Retrieved May 5, The New York Times. Vermont Public Radio. National Bureau of Economic Research.

Retrieved November 21, Retrieved November 13, Author Song, Zirui. Metadata Show full item record. Citation Song, Zirui. Doctoral dissertation, Harvard Medical School. Abstract Background: The United States health care system faces two fundamental challenges: a high growth rate of health care spending and deficiencies in quality of care. To address both of these challenges, public and private payers are increasingly changing the way they pay providers—moving away from fee-for-service towards global payment contracts for groups of providers coming together as accountable care organizations.

Competing interests

This thesis evaluates the change in health care spending and in quality of care associated with moving to global payment for accountable care organizations in Massachusetts in the first 4 years. The AQC pays provider organizations a risk-adjusted global budget for the entire continuum of care for a defined population of enrollees insured by Blue Cross Blue Shield of Massachusetts. It also awards substantial pay-for-performance incentives for organizations meeting performance thresholds on quality measures.

This work assesses its effect on spending and quality through the first 4 years of the contract. Methods: Enrollee-level claims data from were used with a difference-in-differences design to evaluate the changes in spending and quality associated with the Alternative Quality Contract over the first 4 years.

The study population consisted of enrollees in Blue Cross Blue Shield of Massachusetts plans intervention group and enrollees in commercial employer-sponsored plans across 5 comparison states control group. Unadjusted and adjusted results are reported for each comparison between intervention and control. Changes in spending for all 4 AQC cohorts relative to control were evaluated.

In adjusted analyses of spending, I used a multivariate linear model at the enrollee-quarter level, controlling for age, sex, risk score, indicators for intervention, quarters of the study period, the post-intervention period, and the appropriate interactions.